[Congressional Record Volume 148, Number 96 (Tuesday, July 16, 2002)]
[Senate]
[Pages S6815-S6816]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 14TH INTERNATIONAL CONFERENCE ON AIDS

  Mr. DURBIN. Madam President, last Friday, July 12, the 14th 
International Conference on AIDS closed in Barcelona, Spain. This 
year's theme was ``Knowledge and Commitment for Action.''
  More than 14,000 doctors, activists, and government officials 
gathered in Barcelona for the largest AIDS conference ever.
  At the last conference, hosted in Durban, South Africa, in the year 
2000, the concluding plan, by all the nations that assembled, was to 
take action on the following items: To spread the use of condoms as a 
means of avoiding infection; to curb mother-to-child transmission of 
AIDS and HIV; to empower women to choose their relationships and method 
of contraception freely; and, finally, to educate people about the 
risks.
  The last 2 years have shown that all four of these activities can be 
done successfully.
  Another success achieved in the past 2 years is the focus shift to 
providing treatment for all. This has been a result of lower drug costs 
and the realization that people will not get tested unless there is 
hope of treatment.
  The opening session featured the Barcelona Declaration, which called 
for action on the following goals by the year 2004: Secure a donation 
of $10 billion per year for Global AIDS--$10 billion--provide 2 million 
people in the developing world with antiretroviral treatment; third, 
provide affordable drug treatment in the developed world and universal 
access to generic brand drugs in the developing world; and fourth, 
develop a new global partnership between government and nongovernment 
organizations, recognizing the crucial roles that NGOs play in the 
fight against AIDS.

  The Barcelona conference has brought a great deal of attention to 
HIV/AIDS. Newspapers daily provide America with devastating facts. 
UNAIDS warns that the AIDS epidemic is just starting. An estimated 5 
million new HIV infections occurred worldwide during 2001. That is 
about 15,000 infections every single day. More than 95 percent of these 
occur in developing countries. In 2001, 5 infections each minute 
occurred in young people age 15 to 24, approximately 6,000 young people 
in total. Worldwide, 13.4 million children have lost at least 1 parent 
to AIDS. That number is expected to grow to more than 25 million by the 
year 2010.
  We tend to view AIDS and its growth as a Third World problem. We hear 
the statistics: 40 million infected people in sub-Saharan Africa; 15 
million AIDS orphans or more in sub-Saharan Africa; projections by the 
World Bank that there will be over 20 million infected people in India 
alone in the next 5 to 10 years; all of the talk about China and 
Russia.
  Never should we overlook the problem in the United States. AIDS is 
still a problem; HIV infection is a reality. It is growing particularly 
among the African-American population in America. It is growing 
particularly among heterosexuals and among women. This is a problem we 
have not conquered. In fact, we have not confronted it honestly in the 
United States for too long a period of time.
  UNAIDS has just issued a report on the situation in China. The report 
is called ``China's Titanic Peril'' because the U.N. agency said, if 
China doesn't act now, this boat will sink. The Chinese Government 
estimates 850,000 are infected. The U.N. report indicates the Chinese 
Government lacks political commitment and thus far has not provided 
sufficient resources to deal with it. Seventeen percent of the people 
in China have never heard of the disease. China, India, and Indonesia 
are on the brink of outbreaks that could dwarf the current epidemic.
  AIDS is the leading cause of death in sub-Saharan Africa. More than 
28 million Africans are infected with it. HIV/AIDS weakens economic and 
political stability, national security, and agricultural output, all 
necessary for continued development.
  The cost of AIDS rises each minute that the epidemic grows. Without a 
drastic change in the global approach to the HIV/AIDS epidemic, it is 
expected that an additional 45 million people will be living with AIDS 
by 2010. From the facts reported in the daily newspapers, it is clear 
that current spending levels are grievously insufficient to address the 
global epidemic.
  In 1993, experts asked the world for $2 billion annually to slow the 
spread and to save $900 billion in associated costs. Only recently, the 
level of global spending has climbed to $2.8 billion. Think of that, a 
9-year period of time when we did not respond to this epidemic as it 
spun out of control. This is well below the actual need today of $10 
billion every year to fight this epidemic that is circling the globe.
  A World Health Organization mathematical model estimates that only $9 
billion can be usefully spent per year: $4.8 billion on prevention, 
$4.2 billion on treatment. This number assumes the medical 
infrastructures in developing countries will remain at current 
capacities. Jeffrey Sachs, a well-known development economist based at 
Columbia University in New York, suggests that investing in 
infrastructures would raise the yearly cost to about $15 billion.

  I have been to some of these countries suffering with AIDS. Many of 
my colleagues have. You see that the medical infrastructure is 
virtually primitive. Not only do they not have clinics, they don't have 
water that is safe to drink. Imagine trying to treat an epidemic under 
those conditions. An investment in the public health infrastructures of 
these countries can mean we could put money into stopping and slowing 
this epidemic.
  The United States spends more than $10 billion domestically to fight 
the disease, but we contribute only $1.1 billion to fight AIDS abroad. 
A few weeks ago, I brought an amendment to the floor asking that we 
make a commitment on an emergency basis to put $500 million more into 
fighting the AIDS epidemic. I am sorry to report my colleagues would 
not support me on that amendment. It is unfortunate. I believe, sadly, 
that in years to come we will look back on this as a missed opportunity 
to do something about an epidemic that will literally affect the lives 
of all of our children and grandchildren and affect the stability of 
the world.
  What are the contributing causes to the global epidemic? No. 1 is 
lack of education. Eighty percent of those most at risk receive no 
information or any help with prevention. Just a few years back, 10 or 
12 years ago, 30 percent of the pregnant women in Uganda were HIV 
positive. That number is now down to 11 percent. Was there a massive 
infusion of money into Uganda? There was, a selective infusion of money 
into public education. It worked. They preached ABC, which is very 
basic: Abstinence, which is the first advice to be given; make certain 
that if you are going to be sexually active, you are monogamous; and 
third, make certain you rely on condoms for protection if you don't 
accept the other two as a premise for your lifestyle. It is very 
fundamental, but it worked. It dramatically reduced the HIV infection 
rate among those who were pregnant.
  We need programs that are going to change the habits of people. We 
have to understand poverty creates desperation. There is something we 
have to

[[Page S6816]]

understand, which the Presiding Officer made a point of in the city of 
Chicago many years ago after she had returned from a trip to South 
Asia--I heard her speech; I remember it well--in which she said, the 
biggest single indicator of the likelihood of progress in a developing 
nation is the way they treat their women. If women are treated with 
respect, if they are given a voice in the society, if they can help 
decide their fate, you will have a more progressive society; you will 
find a country able to respond to many crises, not just the health 
crisis.
  We in the United States have to understand that though we don't lead 
the world in foreign aid, per capita, we certainly want to make certain 
that our investment in foreign aid focuses on improving the role and 
voice of women in developing countries. Women who are not treated as 
slaves or chattel can make life decisions that will save their lives, 
enrich their children's lives, and give them a marital situation with 
hope instead of despair. That should be part of our approach in dealing 
with AIDS as well.
  This epidemic is going to get worse before it gets better. We have to 
understand that the United States has, beyond a moral responsibility, a 
political responsibility in terms of this HIV/AIDS epidemic. There was 
a time a century ago when the problems around the world were in fact on 
the other side of the world; they couldn't, frankly, make it to the 
United States; many of these people who were sick would die on the way. 
We now know that any problem on the other side of the world is a 10- or 
12-hour airplane flight from being our problem.
  Let us understand we cannot take the current course that is being 
suggested by this administration. To give a symbolic amount of money 
this year to the global AIDS effort is in fact to invite further 
disaster on the people around the world and on the people of the United 
States. To go, as the administration has said, along the route that 
would suggest next year we would make no contribution to the global 
AIDS fund suggests perhaps that they believe the epidemic is going to 
wait for us to catch up with it. It won't. Then finally to say that 
maybe 2 years from now we will put another $300 million in, that kind 
of halfhearted, weak attempt to meet our moral and political obligation 
will mean the AIDS epidemic will continue to grow, not just in Africa, 
not just in Asia, but around the world.
  Taking a meaningful, positive step forward in supporting prevention 
of AIDS research and education is in the best interest of the United 
States.
  I note that major donor organizations such as the Gates Foundation 
and the Kaiser Foundation and others have made a commitment to this. 
The United States has to meet and exceed that commitment as well. We 
have to make certain that the Senate reverses the sad, terrible vote we 
cast just a few weeks ago, saying that we are not going to put more 
money on an emergency basis to fight the AIDS epidemic. I hope my 
colleagues in the Senate, as they reflect on the Barcelona conference 
and the commitment of thousands of leaders around the world, the HIV/
AIDS epidemic, will put pressure on this administration to go beyond 
the rhetoric, beyond juggling the books, about $500 million over a 3-
year period of time, and make a meaningful commitment that will save 
lives.

  I yield the floor.
  The PRESIDING OFFICER. The Senator from Michigan is recognized.

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